MEDICARE: DR. ERIC LIU D.C., CCSP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111NS0005X	Sports Physician Chiropractor	8905	TX
2	111N00000X	Chiropractor	8905	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659347516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC LIU D.C., CCSP

Provider Business Mailing Address
First Line	:	6628 WILCREST DR
Second Line	:	SUITE C
City	:	HOUSTON
State	:	TX
Zip	:	77072-2039
Country	:	US
Telephone Number	:	713-484-7400
Fax Number	:	713-484-7405

Provider Business Practice Location Address
First Line	:	6628 WILCREST DR
Second Line	:	SUITE C
City	:	HOUSTON
State	:	TX
Zip	:	77072-2039
Country	:	US
Telephone Number	:	713-484-7400
Fax Number	:	713-484-7405

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/28/2006
Last Update Date	:	01/18/2024

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